Overall and sex-specific risk factors for subjective cognitive decline: findings from the 2015-2018 Behavioral Risk Factor Surveillance System Survey

The relationship between social networks and subjective cognitive decline in Chinese younger older adults: the mediating effect of self-perception of aging

BACKGROUND

Previous studies have emphasized the impact of social networks on cognitive function, but limited attention has been paid to the relationship between social networks and subjective cognitive decline (SCD) and its underlying mechanisms. To provide a theoretical basis for the prevention and management of SCD, this study aimed to investigate the current situation of social networks and SCD among younger older adults, further elucidate the relationship between them, particularly by comparing the impacts of family networks and friend networks on SCD, and explore the role of self-perception of aging (SPA) as a mediator in above associations.

METHODS

In this cross-sectional study, we surveyed 652 younger older adults from six cities utilizing a general information questionnaire, the Lubben Social Network Scale-6 (LSNS-6), the Subjective Cognitive Decline Questionnaire (SCD-Q9) and the Brief Ageing Perceptions Questionnaire (B-APQ). Regression models were performed to explore the association between social networks and SCD, while the mediating effect of SPA was examined by using the bootstrap method to validate path effects.

RESULTS

Of the participants, 38.04% of individuals had SCD scores above 50. The prevalence of social isolation was 27.5%, with specific rates of 12.3% for family isolation and 44.9% for friend isolation. After adjusting for key demographic characteristics, it was found that social networks (B = -0.05, p < 0.001), especially friend networks (B = -0.07, p < 0.01), were negatively associated with SCD. Additionally, SPA was identified as a partial mediator in the relationship between social networks and SCD (B = -0.007, 95% CI: -0.032, -0.002), as well as friend networks and SCD (B = -0.011, 95% CI: -0.021, -0.004).

CONCLUSIONS

Younger older adults exhibited a high risk of social isolation, with friend isolation being particularly severe. The significant prevalence of SCD among younger older adults has emerged as a pressing health concern. Social networks exhibited a negative association with SCD, with SPA serving as a mediating role in this relationship. Moving forward, comprehensive interventions aimed at addressing SCD in older adults should consider strategies to enhance social networks and improve SPA.

Towards characterizing subjective cognitive decline in older adults

BackgroundSubjective cognitive decline (SCD), where older adults perceive a persistent decline of cognitive abilities without showing an objective cognitive impairment, may represent a preclinical stage of Alzheimer's disease (AD) in some individuals.ObjectiveThe complex characteristics of SCD cannot only be revealed by existing self-report questionnaires. Rather, it is necessary to involve individuals affected in the research process with methods like focus group discussions (FGDs).MethodsStudy conduction took place in three steps: telephone interview, neuropsychological assessment and questionnaires, four FGDs with 16 older adults (11 female, 5 male) affected by SCD. FGDs were analyzed with qualitative content analysis using an inductive - deductive code system.ResultsAlthough the neuropsychological assessments did not indicate a cognitive impairment, participants reported a decline for all cognitive domains within the FGDs, especially for the memory- and speech domain, with declining word-finding abilities as the most salient symptom. Participants reported strong concerns related to SCD and difficulties in social participation.ConclusionsSCD seems to go beyond age-related cognitive changes, but as individuals do not show an objective cognitive impairment (yet), their symptoms are often not taken seriously enough. The FGDs revealed information that questionnaires or neuropsychological tests do not capture. The gained insight into SCD symptoms, related coping strategies and concerns is important to be able to develop measures for identifying individuals at risk for a transition to AD and to develop intervention measures that aim at delaying a further decline and increasing the quality of life of individuals affected.

Vascular risk factor associations with subjective cognitive decline and mild behavioural impairment

Subjective cognitive decline and mild behavioural impairment identify older persons more likely to have early Alzheimer's disease. Vascular co-pathologies may also contribute to new onset and persistent cognitive and behavioural symptoms later in life. We investigated vascular risk factor associations with subjective cognitive decline and mild behavioural impairment. Cross-sectional data for 1285 (81.0% female) participants without mild cognitive impairment or dementia enrolled in the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging were analyzed. Vascular risk factors included body mass index class, self-reported clinician diagnoses of hypertension, high cholesterol, diabetes, self-reported smoking, and the cumulative number of vascular risk factors. Outcomes were the Everyday Cognition scale and Mild Behavioural Impairment Checklist. Logistic and negative binomial regressions were used to model odds and severity of subjective cognitive decline and mild behavioural impairment as a function of individual or cumulative vascular risk factors. Having three or more vascular risk factors (odds ratio = 1.23, 95% confidence interval [1.04-1.47]), actively smoking (odds ratio = 1.54, 95% confidence interval [1.29-1.82]), being overweight (odds ratio = 1.46, 95% confidence interval [1.22-1.74]), and having diabetes (odds ratio = 1.29, 95% confidence interval [1.09-1.53]) were associated with higher odds of subjective cognitive decline. Having any number of vascular risk factors was dose-dependently associated with higher odds of mild behavioural impairment, as were all five vascular risk factors individually; active smokers (odds ratio = 2.67, 95% confidence interval [2.25-3.18]) and obese persons (odds ratio = 2.29, 95% confidence interval [1.91-2.75]) had over twice the odds of mild behavioural impairment. Vascular risk factors associations with subjective cognitive decline were stronger in participants with mild behavioural impairment. All vascular risk factors were linked to higher Everyday Cognition and Mild Behavioural Impairment Checklist total scores, indicating greater subjective cognitive decline and mild behavioural impairment symptom severity. Overweight body mass index, hypertension, and high cholesterol associations with subjective cognitive decline and mild behavioural impairment were stronger in middle-aged adults than older adults, but diabetes and active smoking had greater effects in older adults. Vascular risk factors are strongly related to experiences of cognitive and behavioural changes in later life, even in the absence of objective cognitive impairment. Furthermore, vascular associations with subjective cognitive decline symptoms may be more pronounced in persons with concomitant behavioural decline. Vascular pathologies may contribute to both cognitive and behavioural markers traditionally linked to Alzheimer's disease in older persons, prior to mild cognitive impairment and dementia.

Intersectionality of gender with social determinants of health and asymptomatic Alzheimer's disease neuropathology

BACKGROUND

Women comprise approximately two-thirds of Alzheimer's disease cases.

OBJECTIVE

This is the first known study to investigate the role of intersectionality between gender and other social determinants of health (SDOH) in the presentation of cognitive symptoms (i.e., being asymptomatic or symptomatic) among those with pathologically confirmed Alzheimer's disease.

METHODS

We studied 3107 individuals with Alzheimer's disease neuropathology (ADNP) confirmed at autopsy. Asymptomatic ADNP was defined as the absence of a clinical diagnosis of mild cognitive impairment (MCI) or dementia before death (versus symptomatic: diagnosis of MCI/dementia). SDOH included gender, education, ethnoracial group, living alone, and primary language. Multivariable logistic regression tested associations between SDOH and asymptomatic ADNP (versus symptomatic); models were also stratified by gender.

RESULTS

Women, Hispanics, those living alone, and more educated individuals were found to have higher odds of asymptomatic ADNP. Non-English speakers had lower odds of asymptomatic ADNP. Both women and men had higher odds of asymptomatic ADNP if Hispanic or living alone. In only women, non-English speakers had lower odds while in only men, more education was associated with higher odds of asymptomatic ADNP.

CONCLUSIONS

Gender, education, ethnicity, primary language, and living alone, and intersectionality of gender with primary language, may differentially influence MCI and dementia diagnosis prior to death among those with underlying ADNP. These findings emphasize the need for future Alzheimer's disease research to prioritize social determinants of brain health including their intersectionality with gender and how to inform targeted interventions.

Prevalence and risk factors of subjective cognitive decline in older adults in Baotou, China: a cross-sectional study

Objectives

Subjective cognitive decline (SCD) as a stage between healthy cognition and early neurocognitive disorders, has been proposed to be helpful in the diagnosis of prodromal neurocognitive disorders. To investigate the prevalence of SCD and the related risk factors on the prevalence.

Methods

A cross-sectional study involving 1,120 elderly subjects residing in Baotou, China. From June 2021 to June 2023, the data were gathered by research assistants with training utilizing standardized questionnaires. The following factors were evaluated: subjective cognitive decline, physical and cognitive activity levels, past medical history, demographics, instrumental activities of daily living, and cognitive function. Risk factors of SCD were used chi-square tests and multivariate logistic regression analysis.

Results

The prevalence of SCD was 43.8%. Permanent residence, marital status, BMI, dietary habits, average sleep duration per night, smoking, diabetes, coronary heart disease, and visual impairment were significantly associated with SCD (p < 0 0.05). Multivariable logistic regression analysis showed obesity, vegetarian-based, smoking for a long time, diabetes and coronary heart disease, visual impairment, no spouse, and average sleep duration per night <6 h were independent risk factors for SCD. Based on the gender analysis, the difference in marital status, dietary habits, average sleep duration per night, smoking, drinking, and hypertension was statistically significant (p < 0.001).

Conclusion

The prevalence of subjective cognitive decline was high among elder adults. We discovered significant differences in the prevalence or risk factors for SCD between men and women based on their sex. This study provides a more theoretical basis for the early prevention and screening of cognitive impairment diseases in the elderly population.

Herpes zoster and long-term risk of subjective cognitive decline

BACKGROUND

Herpes zoster (HZ), commonly known as "shingles," may contribute to cognitive decline through mechanisms such as neuroinflammation or direct neuronal injury. However, evidence on the longitudinal association between HZ and cognitive decline is conflicting and whether the risk differs by APOE ε4-carrier status has not been studied; prospective cohort studies on the association between HZ vaccination and cognitive decline are also lacking.

METHODS

We included 149,327 participants from three large cohorts-the Nurses' Health Study (NHS), NHSII, and Health Professionals Follow-Up Study (HPFS)-to prospectively examine the association between HZ and subsequent subjective cognitive decline (SCD). Poisson regression was used to estimate the multivariable-adjusted relative risk (MVRR) of a 3-unit increment in SCD score according to years since HZ compared with participants with no history of HZ.

RESULTS

Compared with individuals with no history of HZ, the MVRR (95% CI) of a 3-unit increment in SCD score was significantly and independently higher among individuals with a history of HZ, but the duration of time since HZ when the elevated risk of SCD was statistically significant differed among the cohorts. In NHS, HZ was associated with higher long-term risk of SCD; compared with individuals with no history of HZ, the MVRR (95% CI) of a 3-unit increment in SCD score was 1.14 (1.01, 1.32) for ≥ 13 years since HZ. In NHS II, HZ was associated with higher risk of SCD in both the short-term [MVRR 1.34 (1.18, 1.53) for 1-4 years] and long-term [MVRR 1.20 (1.08, 1.34) for ≥ 13 years since HZ]. In HPFS, an elevated risk of SCD was suggested across all time points. Among the subset of participants with information on APOE ε4, there was a suggestion that the association differed by APOE ε4 carrier status, but the results were not consistent between women and men. Among the subset of women with information on HZ vaccination, there was a suggestion that the long-term risk of SCD may be greater among women who were not vaccinated against HZ.

CONCLUSIONS

Data from three large independent cohorts of women and men showed that HZ was associated with higher long-term risk of SCD, and the risk may differ by APOE ε4-carrier status.

Association of adverse childhood experiences with poor health condition among middle-aged and elderly adults in the United States: A nationally retrospective cohort study

BACKGROUND

The specific effects of adverse childhood experiences (ACEs) in adulthood and senectitude were less known. We aim to examine the relationship between early ACEs and overall health condition as well as specific dimensions in the middle-aged and elderly population.

METHODS

In the 2019-2021 Behavioral Risk Factor Surveillance System Study, robust Poisson regression models were used to estimate the relationship between ACE exposure and current health status among adults aged 45 ≥ years.

RESULTS

Of the 195,472 participants, 53.8 % were female and the mean age was 65.0 years. Compared to populations without ACE, ACE exposures were more significantly associated with depression (PR: 2.03, 95 %CI: 1.94-2.21), frequent mental health (PR: 1.85, 95 %CI: 1.74-1.97) and subject cognitive decline (PR: 1.99, 95 %CI:1.85-2.14) than with physical health (PR: 1.37, 95 %CI: 1.32-1.44), with dose-response patterns. The association with mental disorder was especially significant among the elderly population.

CONCLUSION

Early ACEs are associated with adverse health outcomes that persist into later life, particularly mental disorders and cognitive decline. Poor mental health may indirectly influence associations with ACEs and cognitive decline as well as physical health. Our findings emphasize the importance of lifelong psychological screening and support for the ACE-exposed middle-aged and elderly population.

Cognitive Symptoms Across Diverse Cancers

Importance

Psychosocial health services for adults with cancer should include support for cognitive symptoms and symptom clusters.

Objective

To characterize the frequency and severity of cognitive symptoms and to identify demographic and clinical risk factors associated with moderate to severe cognitive symptoms among outpatient adults with cancer seeking psychosocial support.

Design, Setting, and Participants

This cross-sectional study analyzed data from routine patient-reported symptom screening during clinic appointments at the Princess Margaret Cancer Centre in Toronto, Canada, between January 1, 2013, and December 31, 2019. Participants were outpatient adults (aged ≥18 years) with diverse cancer diagnoses who endorsed interest in receiving psychosocial support from a health care team member. Data analysis was performed from April 2020 to June 2024.

Main Outcomes and Measures

The presence and severity of cognitive symptoms as self-rated by participants were characterized across 12 cancer types: brain or central nervous system (CNS), breast, gastrointestinal, head and neck, gynecological, thyroid, lung and bronchus, sarcoma, genitourinary, melanoma, hematological, and all other cancers. Multivariable logistic regression was used to explore the associations between demographic, clinical, and symptom factors and moderate to severe cognitive symptoms.

Results

Across the sample of 5078 respondents (2820 females [55.5%]; mean [SD] age at time of survey, 56.0 [14.1] years) requesting psychosocial support, 3480 (68.5%) reported cognitive symptoms of any severity, ranging from 59.5% in sarcoma to 86.5% in brain or CNS cancer. Moderate to severe cognitive symptoms were reported by 1544 patients (30.4%), with the proportions being 51.3% for patients with brain or CNS, 37.0% for breast, 36.2% for thyroid, 30.9% for melanoma, 29.6% for head and neck, 28.3% for gastrointestinal, 28.2% for hematological, 28.1% for gynecological, 24.9% for lung and bronchus, 24.9% for sarcoma, 21.0% for genitourinary, and 26.8% for all other cancers. Across the entire sample, moderate to severe cognitive symptoms were associated with recurrence or progression involving the CNS (odds ratio [OR], 2.62; 95% CI, 1.80-3.81), depression (OR, 1.92; 95% CI, 1.59-2.31), tiredness (OR, 1.82; 95% CI, 1.52-2.19), drowsiness (OR, 1.64; 95% CI, 1.39-1.93), anxiety (OR, 1.57; 95% CI, 1.30-1.89), shortness of breath (OR, 1.38; 95% CI, 1.16-1.61), female sex (OR, 1.33; 95% CI, 1.14-1.56), first-line chemotherapy received (OR, 1.22; 95% CI, 1.05-1.41), and metastatic disease at diagnosis (OR, 0.74; 95% CI, 0.61-0.89). Within individual cancer types, tiredness and depression were consistently associated with moderate to severe cognitive symptoms.

Conclusions and Relevance

This cross-sectional study found that cognitive symptoms were frequently reported by patients across a wide range of cancer types; higher severity of cognitive symptoms was consistently associated with higher symptom burden. The findings could be used to inform decision-making regarding access to cognitive screening, assessment, and supportive care in outpatient oncology clinics.

Psychometric properties and normative data of the Italian version of the Cognitive Function at Work Questionnaire: a screening tool for detecting subjective cognitive complaints at work

INTRODUCTION

Considering the extension of working life due to socioeconomic and political factors, many people may experience cognitive complaints (CC) at their workplace, with severe consequences on their quality of life. The identification of workers reporting significative SCC is crucial to eventually address them to an objective neuropsychological evaluation and implement cognitive interventions to guarantee workers' well-being. Since no Italian questionnaires for detecting CC were designed for occupational settings, the aim of the study was to validate the Italian version of the Cognitive Function at Work Questionnaire (CFWQ) and to provide its normative data.

MATERIALS AND METHODS

Internal consistency, convergent and divergent validity, and factorial structure of the CFWQ were evaluated. A regression-based procedure served to compute percentiles of CFWQ and its subscales.

RESULTS

Four hundred twenty-one participants without psychiatric and/or neurological disorders completed the survey. We found that the Italian CFWQ included 26 items, with a good internal consistency (Cronbach's alpha = 0.897) and a six-factor structure (memory, language, processing speed, abstract thinking/behavioral control, behavioral inertia, planning ability). CFWQ score did not correlate with empathy but correlated strongly with memory scores and moderately with anxiety and depression scores.

CONCLUSIONS

The Italian CFWQ showed good psychometric properties, in analogy with the original English scale. Therefore, it can be successfully employed in organizational contexts to possibly identify workers with CC and therefore with possible co-occurrent psychological, behavioral, and cognitive consequences.

Perceived cognitive impairment is related to internalizing psychopathology but unrelated to objective cognitive performance among nongeriatric adults presenting for outpatient neuropsychological evaluation

Objective: This study investigated the relationship between perceived cognitive impairment, objective cognitive performance, and intrapersonal variables thought to influence ratings of perceived cognitive impairment. Method: Study sample comprised 194 nongeriatric adults who were seen in a general outpatient neuropsychology clinic for a variety of referral questions. The cognition subscale score from the WHO Disability Assessment Schedule served as the measure of perceived cognitive impairment. Objective cognitive performance was indexed via a composite score derived from a comprehensive neuropsychological battery. Internalizing psychopathology was indexed via a composite score derived from anxiety and depression measures. Medical and neuropsychiatric comorbidities were indexed by the number of different ICD diagnostic categories documented in medical records. Demographics included age, sex, race, and years of education. Results: Objective cognitive performance was unrelated to subjective concerns, explaining <1% of the variance in perceived cognitive impairment ratings. Conversely, internalizing psychopathology was significantly predictive, explaining nearly one-third of the variance in perceived cognitive impairment ratings, even after accounting for test performance, demographics, and number of comorbidities. Internalizing psychopathology was also highly associated with a greater discrepancy between scores on perceived and objective cognitive measures among participants with greater cognitive concerns. Clinically significant somatic symptoms uniquely contributed to the explained variance in perceived cognitive impairment (by ∼13%) when analyzed in a model with internalizing symptoms. Conclusions: These findings suggest that perceived cognitive impairment may be more indicative of the extent of internalizing psychopathology and somatic concerns than cognitive ability.

Cognitive and immunological effects of yoga compared to memory training in older women at risk for alzheimer's disease

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) accompanied by cerebrovascular risk factors (CVRFs) are known to increase the risk of developing dementia. Mind-body practices such as yoga and meditation, have been recognized as safe techniques with beneficial effects on cognitive functions in older adults at risk for cognitive decline. We conducted a randomized, controlled trial to assess the efficacy of Kundalini yoga training (KY) compared to memory enhancement training (MET) on mood and cognitive functioning in a group of older women with CVRFs and SCD (clinicaltrials.gov = NCT03503669). The KY intervention consisted of weekly, 60-min in-person classes with a certified instructor for 12 weeks, with a 12-min guided recording for daily homework practice at home. MET involved 12 weekly in-person group classes with 12-min daily homework exercises. Objective and subjective memory performance were the primary outcomes. Peripheral whole blood samples were collected at baseline, 12-weeks, and 24-weeks follow-up for RNA sequencing and cytokine/chemokine assays. A total of 79 patients (KY = 40; MET = 39) were randomized, and 63 completed the 24-week follow-up (KY = 65% completion rate; MET = 95%; χ2(1) = 10.9, p < 0.001). At 24-weeks follow-up, KY yielded a significant, large effect size improvement in subjective cognitive impairment measures compared to MET. KYOn a transcriptional level, at 12- and 24-week follow-up, KY uniquely altered aging-associated signatures, including interferon gamma and other psycho-neuro-immune pathways. Levels of chemokine eotaxin-1, an aging marker, increased over time in MET but not KY participants. These results suggest clinical and biological benefits to KY for SCD, linking changes in cognition to the anti-inflammatory effects of yoga.

Improvement of frailty prevalence: difference in factors affecting frailty prevalence among 75 year-old individuals between 2006 and 2019

[Purpose] This study aimed to examine and compare the prevalence of frailty in 75 year-old people sampled in two remote years, namely 2006 and 2019. [Participants and Methods] A total of 910 participants aged 75 years were included (502 people in 2006 and 408 people in 2019). We compared the total score of the Kihon checklist and each question for males and females between the two years. [Results] The prevalence of frailty decreased from 24.3% in 2006 to 15.2% in 2019. The comparison of the 2006 and 2019 Kihon checklists revealed significant differences in activities of daily living, physical function, oral function, outdoor activities, and cognitive function. [Conclusion] Frailty among 75 year-old individuals improved in 2019 compared to that in 2006. Improved activities of daily living, physical function, outdoor activities, and cognitive function were major causes of improved frailty in 2019.

Associations of Depressive Symptoms with Subjective Cognitive Decline in Elderly People-A Cross-Sectional Analysis from the AgeWell.de-Study

To develop effective dementia prevention strategies, it is necessary to understand risk factors, associated factors and early signs of dementia. Subjective cognitive decline (SCD) is the earliest form of dementia. The aim of this study is to assess depression as a factor that is significantly associated with SCD. The data of 1030 general practitioner patients from the AgeWell.de-study (60-77 years; CAIDE dementia risk score ≥ 9) were analysed. A descriptive analysis was conducted using validated instruments like the Geriatric depression scale (GDS), Lubben social network scale (LSNS-6) and education classes according to CASMIN (Comparative Analysis of Social Mobility in Industrial Nations). A multivariate regression model with the dependent variable SCD was calculated. Of the 1030 participants, 5.9% had depressive symptoms and 31.3% SCD. The group with depressive symptoms showed significantly higher body-mass-index (p = 0.005), lower education class (p = 0.022), lower LSNS-6 score (p < 0.001), higher sports activity (p < 0.001), and more sleeping problems (p = 0.026). In the regression model a higher GDS-score [Odds ratio (OR): 1.219 (p < 0.001)], more sleeping problems [OR: 1.550 (p = 0.017)] and higher education class [middle/high: OR: 1.474/1.875 (p = 0.037/0.004)] were significantly associated with SCD. This study identified depressive symptoms, sleeping problems, and higher education classes as factors associated with SCD, which can represent an early form of dementia.

Xanthohumol improves cognitive impairment by regulating miRNA-532-3p/Mpped1 in ovariectomized mice

RATIONALE

Studies have shown the potential neuroprotective effect of xanthohumol, while whether xanthohumol has the ability of repairing cognitive impairment and its underlying mechanism still remains obscure.

OBJECTIVES

To unravel the mechanism of xanthohumol repairing cognitive impairment caused by estrogen deprivation.

METHODS

C57BL/6 J female mice that underwent bilateral ovariectomy to establish cognitive decline model were randomly divided into three xanthohumol-treated groups and a saline-treated model group. For identifying the neuroprotective function of xanthohumol, Morris water maze (MWM) test and open field test (OFT) were conducted. After extracting total RNA of mouse hippocampus of different groups, mRNA-seq and microRNA (miRNA)-seq analysis were performed, and the differentially expressed miRNAs (DEMIs) and their target genes were further validated by qPCR. MiR-532-3p and its downstream gene Mpped1 were screened as targets of xanthohumol. Influence of miR-532-3p/Mpped1 to cognitive ability was examined via MWM test and OFT after stereotactic brain injection of Mpped1 overexpressed adeno-associated virus. The regulation of miR-532-3p on Mpped1 was confirmed in hippocampal neuronal cell line HT22 by luciferase reporter gene assay.

RESULTS

Xanthohumol treatment reversed the cognitive decline of OVX mice according to behavioral tests. By comparing miRNA levels of xanthohumol-treated groups with saline-treated group, we found that the main changed miRNAs were miR-122-5p, miR-532-3p, and miR-539-3p. Increased miR-532-3p in OVX mice was suppressed by xanthohumol treatment. Furthermore, the downstream gene of miR-532-3p, Mpped1, was also increased by xanthohumol and showed the capability of relieving cognitive impairment of OVX mice after overexpressed in hippocampus. The 3' untranslated region of Mpped1 was identified as the target region of miR-532-3p, and agomiR-532-3p remarkably reduced the expression of Mpped1 mRNA.

CONCLUSIONS

Xanthohumol has the ability of repairing cognitive impairment through removing the inhibition of miR-532-3p on Mpped1 in mouse hippocampus. This finding not only advances the understanding of neuroprotective mechanism of xanthohumol, but also provides novel treatment targets for dementia of postmenopausal women.

Mental Fatigue Is Associated with Subjective Cognitive Decline among Older Adults

Both Subjective Cognitive Decline (SCD) and mental fatigue are becoming increasingly prevalent as global demographics shifts indicate our aging populations. SCD is a reversible precursor for Alzheimer's disease, and early identification is important for effective intervention strategies. We aim to investigate the association between mental fatigue-as well as other factors-and SCD. A total of 707 old adults (aged from 60 to 99) from Shanghai, China, participated in this study and completed self-reported instruments covering their cognitive and mental status as well as demographic information. Mental fatigue status was assessed by using four items derived from the functional impairment syndrome of the Old Adult Self Report (OASR). SCD was assessed by using the Memory/Cognition syndrome of OASR. A total of 681 old adults were included in the current study. The means of SCD significantly differed between each group of factors (age, gender, and mental fatigue). The general linear regression models showed that SCD increased with age, females scored higher than males, and SCD was positively associated with mental fatigue factors including difficulty getting things done, poor task performance, sleeping more, and a lack of energy among old adults. The study also found that SCD is negatively associated with the high-income group among young-old (aged from 60 to 75) males and associated with good marital/living status with the companion of spouses/partners among young-old females. These results suggest that gender, income level, marital/living status, and mental fatigue are crucial factors in preventing SCD among old adults and are pivotal in developing early intervention strategies to preserve the mental health of an increasingly aging population.

How preclinical models of menopause can inform clinical care: A focus on midlife and reciprocal communication between clinical and preclinical science

Midlife in women typically includes the menopausal transition, a time of hormonal transformation, adaptation, and reorganization. Coincident with this dynamic period of physiological change, there are putatively modifiable factors that influence disease, short-term and long-term health outcomes, symptom emergence, and longevity. The menopause transition could be considered a window of vulnerability; however, it is also a window of opportunity for intervention. Thus, the menopause transition is a critical sensitive window whereby there is opportunity for turning points for healthy aging trajectories. Preclinical research can aid in this pursuit of scientific discovery for modifiable factors and treatments, and their particular parameters. Rodent menopause models include surgical and transitional variations, allowing detection of precise determinants impacting menopause-related outcomes. These models permit systematic manipulation of endogenous and exogenous hormone exposures across the lifespan, with infinite outcome measurements ranging from molecular to behavioral. This research is uniquely poised to address complex, interactive hypotheses with extensive control in a relatively short timeframe, including dissociation of age and menopause effects. To understand the many dynamic changes with menopause, iterative and reciprocal communication between clinical and preclinical domains of science is key.